101
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Danielsson D, Munck-Wikland E, Hagel E, Halle M. Quality of life after microvascular mandibular reconstruction for osteoradionecrosis-A prospective study. Head Neck 2019; 41:2225-2230. [PMID: 30721560 DOI: 10.1002/hed.25681] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/30/2018] [Accepted: 01/15/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Reconstructive surgery for mandibular osteoradionecrosis is increasing; however, evidence regarding the impact on health-related quality of life is lacking. The current exploratory study prospectively investigates whether resection with reconstruction is associated with changes in HRQoL parameters for these patients. METHODS Seventeen patients underwent microvascular reconstruction for mandibular osteoradionecrosis between 2012 and 2015, and 16 completed the EORTC quality of life questionnaires QLQ-C30 and QLQ-H&N35 1 month before and 1 year after surgery. RESULTS Increases in emotional (P = 0.01) and social functioning (P = 0.004) were observed, together with improvements in the fatigue (P = 0.04), appetite loss (P = 0.02) and pain (P = 0.02) scores, as evaluated by the QLQ-C30. Pain reduction was further confirmed by the QLQ-H&N35 (P = 0.04), which also showed improved scores for feeling ill (P = 0.001) and sexual difficulties (P = 0.04). CONCLUSION This exploratory study suggests that microvascular reconstruction after mandibular osteoradionecrosis may improve HRQoL, with an emphasis on pain reduction; however, further studies are needed.
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Affiliation(s)
- Daniel Danielsson
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden.,Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Munck-Wikland
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden.,Department of Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Hagel
- Medical Statistics Unit, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Martin Halle
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden
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102
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Gleber-Netto FO, Rao X, Guo T, Xi Y, Gao M, Shen L, Erikson K, Kalu NN, Ren S, Xu G, Fisch KM, Akagi K, Seiwert T, Gillison M, Frederick MJ, Johnson FM, Wang J, Myers JN, Califano J, Skinner HD, Pickering CR. Variations in HPV function are associated with survival in squamous cell carcinoma. JCI Insight 2019; 4:124762. [PMID: 30626753 DOI: 10.1172/jci.insight.124762] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/27/2018] [Indexed: 12/25/2022] Open
Abstract
Incidence of HPV+ oropharyngeal squamous cell carcinoma (OPSCC) has been increasing dramatically. Although long-term survival rates for these patients are high, they often suffer from permanent radiotherapy-related morbidity. This has prompted the development of de-escalation clinical protocols to reduce morbidity. However, a subset of patients do not respond even to standard therapy and have poor outcomes. It is unclear how to properly identify and treat the high- and low-risk HPV+ OPSCC patients. Since HPV positivity drives radiotherapy sensitivity, we hypothesized that variations in HPV biology may cause differences in treatment response and outcome. By analyzing gene expression data, we identified variations in HPV-related molecules among HPV+ OPSCC. A subset of tumors presented a molecular profile distinct from that of typical HPV+ tumors and exhibited poor treatment response, indicating molecular and clinical similarities with HPV- tumors. These molecular changes were also observed in vitro and correlated with radiation sensitivity. Finally, we developed a prognostic biomarker signature for identification of this subgroup of HPV+ OPSCC and validated it in independent cohorts of oropharyngeal and cervical carcinomas. These findings could translate to improved patient stratification for treatment deintensification and new therapeutic approaches for treatment-resistant HPV-related cancer.
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Affiliation(s)
| | - Xiayu Rao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas. USA
| | - Theresa Guo
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Yuanxin Xi
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas. USA
| | - Meng Gao
- Department of Head and Neck Surgery and
| | - Li Shen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas. USA
| | | | - Nene N Kalu
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shuling Ren
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Guorong Xu
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Kathleen M Fisch
- Center for Computational Biology & Bioinformatics, Department of Medicine, University of California, San Diego, La Jolla, California. USA
| | - Keiko Akagi
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tanguy Seiwert
- Department of Medicine and Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, USA
| | - Maura Gillison
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Faye M Johnson
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas. USA.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Jeffrey N Myers
- Department of Head and Neck Surgery and.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Joseph Califano
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Heath D Skinner
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Curtis R Pickering
- Department of Head and Neck Surgery and.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
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103
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Janz TA, Momin SR, Sterba KR, Kato MG, Armeson KE, Day TA. Comparison of psychosocial factors over time among HPV+ oropharyngeal cancer and tobacco-related oral cavity cancer patients. Am J Otolaryngol 2019; 40:40-45. [PMID: 30322742 DOI: 10.1016/j.amjoto.2018.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The role of human papilloma virus (HPV) in the pathogenesis of oropharyngeal squamous cell carcinoma (OPSCC) is well documented, as is the excellent prognosis of patients with HPV-associated disease; in contrast, oral cavity squamous cell carcinoma (OCSCC) is associated with tobacco and alcohol use and has a worse prognosis. While causative factors, staging, and treatment guidelines differ between these cancer subsets, few studies have compared psychosocial factors in these groups. OBJECTIVE To explore differences in psychosocial factors between HPV+ OPSCC patients versus OCSCC smokers. METHODS A prospective cohort study at a single multidisciplinary, tertiary care HNC center was completed with recruitment from 2010 to 2013 using self-administered questionnaires before treatment and at 12 months. Patients were included with a diagnosis of HPV+ OPSCC or OCSCC with a smoking history. 38 (21 HPV+ OPSCC/17 OCSCC) met criteria. The main outcomes included self-efficacy, symptom severity, cancer worry, and depression. RESULTS A total of 38 (21 HPV+ OPSCC/17 OCSCC) patients (mean age: 57 [32-76], 73.7% male, 78.9% Caucasian, 71% stage IV) met inclusion criteria. OPSCC patients tended to be of male sex, Caucasian race, and single. Furthermore, OPSCC patients were more likely than OCSCC patients to have private insurance, be employed, and use alcohol and tobacco less frequently. Regarding psychosocial factors, HPV+ OPSCC patients reported lower symptom severity (2.7 versus 3.3), depression (12.0 versus 14.0) and cancer worry (2.8 versus 3.2) at baseline compared to OCSCC patients. Depression decreased significantly over time in OPSCC patients (12.0 to 9.9; effect size: -3.2 (95% CI: -5.9 to -0.4)). Although not statistically significant, cancer worry decreased in both groups (2.8 to 2.4 and 3.2 to 2.7, respectively, effect sizes: -0.3 (95% CI: -0.7-0.08) and -0.6 (95% CI: -1.2-0.05), respectively). No statistically significant differences in patterns of change over time were noted between groups. CONCLUSIONS AND RELEVANCE This pilot study highlighted a pattern of reduced quality of life parameters in OCSCC patients at baseline with similar improvements over time compared to the OPSCC cohort. Although different in cancer etiology and treatment plans, HPV+ OPSCC and tobacco-related OCSCC patients both require multidisciplinary cancer care plans that address psychosocial concerns. LEVEL OF EVIDENCE 2B.
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Affiliation(s)
- Tyler A Janz
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; University of Central Florida College of Medicine, Orlando, FL, United States of America.
| | - Suhael R Momin
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, MI, United States of America
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | - Masanari G Kato
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; Stony Brook University School of Medicine, Stony Brook, New York, United States of America
| | - Kent E Armeson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | - Terry A Day
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America
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104
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Comparative effectiveness of primary radiotherapy versus surgery in elderly patients with locally advanced oropharyngeal squamous cell carcinoma. Oral Oncol 2019; 88:18-26. [DOI: 10.1016/j.oraloncology.2018.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/26/2018] [Accepted: 11/03/2018] [Indexed: 11/19/2022]
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105
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Tiedemann D, Jakobsen KK, von Buchwald C, Grønhøj C. Systematic review on location and timing of distant progression in human papillomavirus-positive and human papillomavirus-negative oropharyngeal squamous cell carcinomas. Head Neck 2018; 41:793-798. [DOI: 10.1002/hed.25458] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Daniel Tiedemann
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Kathrine Kronberg Jakobsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
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106
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Sibeoni J, Picard C, Orri M, Labey M, Bousquet G, Verneuil L, Revah-Levy A. Patients' quality of life during active cancer treatment: a qualitative study. BMC Cancer 2018; 18:951. [PMID: 30286733 PMCID: PMC6172766 DOI: 10.1186/s12885-018-4868-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patients' quality of life has become a major objective of care in oncology. At the same time, it has become the object of increasing interest by researchers, working with both quantitative and qualitative methods. Progress in oncology has enabled more patients to survive longer, so that cancer is increasingly often a chronic disease that requires long-term treatment that can have negative effects on patients' quality of daily life. Nonetheless, no qualitative study has explored what patients report affects their quality of daily life during the treatment period. This study is intended to fill this gap. METHODS We conducted a multicenter qualitative study based on 30 semi-structured interviews. Participants, purposively selected until data saturation, had diverse types of cancer and had started treatment at least 6 months before interview. Data were examined by thematic analysis. RESULTS Our analysis found two themes: (1) what negatively affected for patient's quality of daily life during the treatment period, a question to which patients responded by talking only about the side effects of treatment; and (2) what positively affected their quality of daily life during the treatment period with three sub-themes: (i) The interest in having -investing in - a support object that can be defined as an object, a relationship or an activity particularly invested by the patients which makes them feel good and makes the cancer and its treatment bearable, (ii)The subjective perception of the efficacy of the antitumor treatment and (iii) the positive effects of relationships, with friends and family, and also with their physician. CONCLUSIONS Patients must be involved in their care if they are to be able to bear their course of treatment and find ways to endure the difficult experience of cancer care. The support object represents an important therapeutic lever that can be used by their oncologists. They should be interested in their support objects, in order to support the patients in this investment and to help them to maintain it throughout the health care pathway. Furthermore, showing interest in this topic, important to the patient, could improve the physician-patient relation without using up very much of the physician's time.
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Affiliation(s)
- Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud'hon, 95107, Argenteuil, France. .,ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.
| | - Camille Picard
- Department of Dermatology, Caen University Hospital, F-14033, Caen, France.,Université de Caen Normandie, Medical School, F-14000, Caen, France
| | - Massimiliano Orri
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.,McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada
| | - Mathilde Labey
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.,EPSM Lille métropole, pôle de psychiatrie adulte 59g21, Lille, France
| | - Guilhem Bousquet
- Université Paris 13 - Léonard de Vinci, Villetaneuse, France.,AP-HP-Hôpital Avicenne, Service d'Oncologie médicale-Bobigny, Bobigny, France
| | - Laurence Verneuil
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud'hon, 95107, Argenteuil, France.,ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France
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107
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Windon MJ, D'Souza G, Fakhry C. Treatment preferences in human papillomavirus-associated oropharyngeal cancer. Future Oncol 2018; 14:2521-2530. [PMID: 30265132 PMCID: PMC6275561 DOI: 10.2217/fon-2018-0063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/09/2018] [Indexed: 01/18/2023] Open
Abstract
The population of survivors with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) is rising. The improved prognosis of this etiologic subset is reflected in new staging guidelines as well as ongoing deintensification trials aiming to preserve excellent survival while decreasing treatment-related toxicities. However, as staging criteria and treatment standards evolve in the era of transoral surgery and deintensification, little is known regarding the needs and treatment preferences of patients with HPV-OPSCC. Herein, the current knowledge regarding treatment preferences and priorities, quality of life and concerns among patients with HPV-OPSCC is reviewed.
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Affiliation(s)
- Melina J Windon
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Gypsyamber D'Souza
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Carole Fakhry
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Bloomberg–Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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108
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Marzouki HZ, Biron VL, Dziegielewski PT, Ma A, Vaz J, Constantinescu G, Harris J, O'Connell D, Seikaly H. The impact of human papillomavirus (HPV) status on functional outcomes and quality of life (QOL) after surgical treatment of oropharyngeal carcinoma with free-flap reconstruction. J Otolaryngol Head Neck Surg 2018; 47:58. [PMID: 30231911 PMCID: PMC6146510 DOI: 10.1186/s40463-018-0301-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 08/26/2018] [Indexed: 12/19/2022] Open
Abstract
Background To determine the impact of Human Papillomavirus (HPV) status on speech, swallowing, and quality of life (QOL) outcomes after surgical treatment of oropharyngeal cancer (OPSCC). Methods A retrospective review of a prospectively collected database of all patients with OPSCC diagnosed and treated from 1998 to 2009. Speech, swallowing, and quality of life data were gathered at 3 different evaluation points. HPV status was determined using p16 positivity as a surrogate marker. Univariate and multivariate statistical analyses were performed to identify whether p16 status is a significant predictor of functional outcome and QOL. Results One hundred twelve patients with OPSCC and known p16 status were treated with primary surgery between 1998 and 2009, with mean age of 56 years. Out of those patients 63 (56%) were p16 positive. Speech intelligibility remained high at 1-year post operation (95.4%). Only 11.5% of the patients required a feeding tube at 1 year after surgery to maintain their daily caloric requirements and the risk of aspiration after surgery was not significant (p = 0.097). There was no statistically or clinically significant difference in speech, swallowing ability, swallowing safety and QOL outcomes between p16-positive and negative OPSCC. Conclusions Surgically treated OPSCC patients demonstrate excellent swallowing function and can achieve excellent speech perception. P16 status may not be predictive of functional outcomes or QOL in surgically treated OPSCC.
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Affiliation(s)
- Hani Z Marzouki
- Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Vincent L Biron
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Peter T Dziegielewski
- Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Otolaryngology, University of Florida, Florida, USA
| | - Andrew Ma
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Jason Vaz
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Gabriela Constantinescu
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Jeffrey Harris
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Daniel O'Connell
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
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109
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Teraoka S, Kakei Y, Akashi M, Iwata E, Hasegawa T, Miyawaki D, Sasaki R, Komori T. Gold nanoparticles enhance X-ray irradiation-induced apoptosis in head and neck squamous cell carcinoma in vitro. Biomed Rep 2018; 9:415-420. [PMID: 30345038 DOI: 10.3892/br.2018.1142] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 07/24/2018] [Indexed: 12/26/2022] Open
Abstract
Enhancing the antitumor effect of radiation, while reducing damage to organs, is a significant challenge in radiation therapy for head and neck malignancies. One promising radiosensitizer is gold. The present study aimed to determine whether gold nanoparticles (AuNPs) have the potential to enhance the effects of X-ray irradiation on head and neck cancer cells. The human head and neck carcinoma cell line HSC-3 was used. Total cell number and the levels of cell proliferation and apoptosis were compared between control cells and cells treated with 5-nm AuNPs alone at four concentrations (0.1, 0.4, 1.0 and 10.0 nM), X-ray irradiation alone at three doses (2, 4 and 8 Gy), or a combination of 4 Gy X-ray irradiation and 1.0 nM AuNPs. Analysis of variance and Tukey-Kramer testing were performed to compare the different groups. The total number of cells significantly decreased following 4 and 8 Gy X-ray irradiation, compared with in the control group (control vs. 4Gy, P=2.19×10-4; control vs. 8Gy, P=1.28×10-6). The combination of 4 Gy X-ray irradiation and 1.0 nM AuNPs significantly reduced the total number of cells compared with 4 Gy X-ray irradiation alone (P=2.95×10-4). Cell proliferation was not affected by AuNP treatment alone, 4 Gy X-ray irradiation alone or the combination of X-ray irradiation and AuNPs. The combination of 4 Gy irradiation and 1.0 nM AuNPs significantly increased the number of apoptotic cells compared with 4 Gy irradiation alone (P=0.0261). In conclusion, AuNPs combined with X-ray irradiation enhanced the cytotoxic effect on human head and neck cancer cells in vitro, through the induction of apoptosis, but not inhibition of cell proliferation.
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Affiliation(s)
- Shun Teraoka
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Eiji Iwata
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Daisuke Miyawaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Takahide Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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110
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Kreimer AR, Shiels MS, Fakhry C, Johansson M, Pawlita M, Brennan P, Hildesheim A, Waterboer T. Screening for human papillomavirus-driven oropharyngeal cancer: Considerations for feasibility and strategies for research. Cancer 2018; 124:1859-1866. [PMID: 29499070 DOI: 10.1002/cncr.31256] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 01/04/2023]
Abstract
The incidence and burden of human papillomavirus (HPV)‐driven oropharyngeal cancer is expected to increase for decades, thus motivating discussions regarding possibilities for screening. This article addresses issues related to the validity and timeliness of screening for HPV‐driven oropharyngeal cancer, and raises important questions, highlights deficits and confusion in the existing literature, and proposes needed steps in the research agenda.
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Affiliation(s)
- Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Carole Fakhry
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland
| | | | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
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111
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Verma A, Rich LJ, Vincent-Chong VK, Seshadri M. Visualizing the effects of metformin on tumor growth, vascularity, and metabolism in head and neck cancer. J Oral Pathol Med 2018; 47:484-491. [PMID: 29573032 DOI: 10.1111/jop.12705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The antidiabetic drug metformin (Met) is believed to inhibit tumor proliferation by altering the metabolism of cancer cells. In this study, we examined the effects of Met on tumor oxygenation, metabolism, and growth in head and neck squamous cell carcinoma (HNSCC) using non-invasive multimodal imaging. MATERIALS AND METHODS Severe combined immunodeficient (SCID) mice bearing orthotopic FaDu HNSCC xenografts were treated with Met (200 mg/kg, ip) once daily for 5 days. Tumor oxygen saturation (%sO2 ) and hemoglobin concentration (HbT) were measured using photoacoustic imaging (PAI). Fluorescence imaging was employed to measure intratumoral uptake of 2-deoxyglucosone (2-DG) following Met treatment while magnetic resonance imaging (MRI) was utilized to measure tumor volume. Correlative immunostaining of tumor sections for markers of proliferation (Ki67) and vascularity (CD31) was also performed. RESULTS At 5 days post-Met treatment, PAI revealed a significant increase (P < .05) in %sO2 and HbT levels in treated tumors compared to untreated controls. Fluorescence imaging at this time point revealed a 46% decrease in mean 2-DG uptake compared to controls. No changes in hemodynamic parameters were observed in mouse salivary gland tissue. A significant decrease in Ki-67 staining (P < .001) and MR-based tumor volume was also observed in Met-treated tumors compared to controls with no change in CD31 + vessel count following Met therapy. CONCLUSION Our results provide, for the first time, direct in vivo evidence of Met-induced changes in tumor microenvironmental parameters in HNSCC xenografts. Our findings highlight the utility of multimodal functional imaging for non-invasive mapping of the effects of Met in HNSCC.
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Affiliation(s)
- Aparajita Verma
- Department of Oral Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Molecular and Cellular Biophysics and Biochemistry, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Laurie J Rich
- Department of Oral Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Molecular and Cellular Biophysics and Biochemistry, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Head and Neck Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
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112
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Grønhøj C, Jensen DH, Vester-Glowinski P, Jensen SB, Bardow A, Oliveri RS, Fog LM, Specht L, Thomsen C, Darkner S, Jensen M, Müller V, Kiss K, Agander T, Andersen E, Fischer-Nielsen A, von Buchwald C. Safety and Efficacy of Mesenchymal Stem Cells for Radiation-Induced Xerostomia: A Randomized, Placebo-Controlled Phase 1/2 Trial (MESRIX). Int J Radiat Oncol Biol Phys 2018; 101:581-592. [PMID: 29678523 DOI: 10.1016/j.ijrobp.2018.02.034] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/30/2018] [Accepted: 02/21/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Salivary gland hypofunction and xerostomia are major complications to head and neck radiotherapy. This trial assessed the safety and efficacy of adipose tissue-derived mesenchymal stem cell (ASC) therapy for radiation-induced xerostomia. PATIENT AND METHODS This randomized, placebo-controlled phase 1/2 trial included 30 patients, randomized in a 1:1 ratio to receive ultrasound-guided transplantation of ASCs or placebo to the submandibular glands. Patients had previously received radiotherapy for a T1-2, N0-2A, human papillomavirus-positive, oropharyngeal squamous cell carcinoma. The primary outcome was the change in unstimulated whole salivary flow rate, measured before and after the intervention. All assessments were performed one month prior (baseline) and one and four months following ASC or placebo administration. RESULTS No adverse events were detected. Unstimulated whole salivary flow rates significantly increased in the ASC-arm at one (33%; P = .048) and four months (50%; P = .003), but not in the placebo-arm (P = .6 and P = .8), compared to baseline. The ASC-arm symptom scores significantly decreased on the xerostomia and VAS questionnaires, in the domains of thirst (-22%, P = .035) and difficulties in eating solid foods (-2%, P = .008) after four months compared to baseline. The ASC-arm showed significantly improved salivary gland functions of inorganic element secretion and absorption, at baseline and four months, compared to the placebo-arm. Core-needle biopsies showed increases in serous gland tissue and decreases in adipose and connective tissues in the ASC-arm compared to the placebo-arm (P = .04 and P = .02, respectively). MRIs showed no significant differences between groups in gland size or intensity (P < .05). CONCLUSIONS ASC therapy for radiation-induced hypofunction and xerostomia was safe and significantly improved salivary gland functions and patient-reported outcomes. These results should encourage further exploratory and confirmatory trials.
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Affiliation(s)
- Christian Grønhøj
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - David H Jensen
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Vester-Glowinski
- Department of Plastic Surgery, Breast Surgery and Burns Treatment, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Siri Beier Jensen
- Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark; Section of Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Allan Bardow
- Section of Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Roberto S Oliveri
- Cell Therapy Facility, The Blood Bank, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lea Munthe Fog
- Cell Therapy Facility, The Blood Bank, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Thomsen
- Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sune Darkner
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Michael Jensen
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Vera Müller
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tina Agander
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elo Andersen
- Department of Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne Fischer-Nielsen
- Cell Therapy Facility, The Blood Bank, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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113
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Transoral robotic surgery-based therapy in patients with stage III-IV oropharyngeal squamous cell carcinoma. Oral Oncol 2017; 75:16-21. [DOI: 10.1016/j.oraloncology.2017.10.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/07/2017] [Accepted: 10/13/2017] [Indexed: 01/03/2023]
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114
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Bozec A, Demez P, Gal J, Chamorey E, Louis MY, Blanchard D, De Raucourt D, Merol JC, Brenet E, Dassonville O, Poissonnet G, Santini J, Peyrade F, Benezery K, Lesnik M, Berta E, Ransy P, Babin E. Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study. Surg Oncol 2017; 27:23-30. [PMID: 29549900 DOI: 10.1016/j.suronc.2017.11.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/25/2017] [Accepted: 11/22/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores. CONCLUSIONS Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.
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Affiliation(s)
- Alexandre Bozec
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France.
| | - Pierre Demez
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liège, Belgium
| | - Jocelyn Gal
- Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Marie-Yolande Louis
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - David Blanchard
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - Dominique De Raucourt
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - Jean-Claude Merol
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, France
| | - Esteban Brenet
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, France
| | - Olivier Dassonville
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Gilles Poissonnet
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - José Santini
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Frédéric Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Maria Lesnik
- Department of Otorhinolaryngology and Head and Neck Surgery, Institut Curie, Paris, France
| | - Etienne Berta
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital of Annecy, France
| | - Pierre Ransy
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liège, Belgium
| | - Emmanuel Babin
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Caen, France
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